Authors: Bing-Cheng Zhao, M.D. et al Anesthesiology September 2024, Vol. 141, 475–488. Background Patients undergoing noncardiac surgery have varying risk of cardiovascular complications. This study evaluated preoperative N-terminal pro–B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T to enhance cardiovascular events prediction for major noncardiac surgery. Methods This prospective cohort study included adult patients with cardiovascular […]
METHODS OF MYOCARDIAL MANAGEMENT DURING CARDIAC SURGERY
Cardiac Anesthesiologist Feedspot Moderately Hypothermic Intermittent Global Myocardial Ischemia Intermittent cardiac ischemia with moderate cardiac hypothermia requires performing cardiopulmonary bypass (CPB) with a perfusate temperature between 25°C and 30°C. During this method, the surgeon operates on or in the heart for 10 to 15 minutes while the ascending aorta is clamped (stopping coronary perfusion) or individual […]
Sublingual Hematoma: A Rare Anesthetic Complication
Authors: Adam Warrick, M.D. et al Anesthesiology August 2024. These images demonstrate sublingual hematoma progression in a patient presenting for repeat laparoscopy after cholecystectomy complicated by incomplete hemostasis (fig.1, A to C, arrows). On postoperative day one, the patient reported frenulum tenderness, purpura, and an expanding mass beneath her tongue (fig.1, A). Otolaryngology evaluation was obtained, […]
Use of Neuromuscular Blocking and Antagonism Agents across the Spectrum of Renal Impairment Undergoing Major Inpatient Surgery
Authors: Douglas A. Colquhoun, M.B., Ch.B., M.Sc., M.P.H. et al Anesthesiology September 2024, Vol. 141, 602–607. To the Editor: Cisatracurium has traditionally been utilized in patients with severe renal impairment due to its clearance by Hoffman elimination. However, cisatracurium cannot be antagonized by sugammadex, which is specific to rocuronium and vecuronium. Sugammadex, compared to neostigmine, reduces […]
Science, Medicine, and the Anesthesiologist
Anesthesiology September 2024, Vol. 141, A13–A15. Large language model capabilities in perioperative risk prediction and prognostication. JAMA Surg 2024; e241621 Large language models (LLMs) like ChatGPT are widely used, but their use for perioperative care applications is uncertain. This retrospective prognostic study studied six different “prompting strategies” for question-and-answer tasks using GPT-4 Turbo (OpenAI) on 133,500 […]
Discover The Best Anesthesiologist Opportunity in New Mexico
We are seeking a dedicated anesthesiologist to join our all-anesthesiologist group. Our team will consist of 4 full-time providers and 1 for vacation relief, managing 3 operating rooms. Position Highlights: Zero call for 3 weeks, followed by 1 week of call without daytime work only call after 7 PM therefore you may not work the […]
Improving Pain Management after Tonsillectomy
Authors: Charles B. Berde, M.D., Ph.D.; Michael J. Cunningham, M.D. Anesthesiology September 2024, Vol. 141, 425–427. Tonsillectomy is among the most common of pediatric operations. In this issue of Anesthesiology, Einhorn et al. report on a prospective controlled trial of single-dose intravenous methadone administered intraoperatively to children and adolescents ages 3 to 17 yr undergoing elective tonsillectomy with or […]
DIRECT LARYNGOSCOPY: BASIC SKILL OR OBSOLETE TECHNOLOGY?
Author: Richard Novak, MD The Anesthesia Consultant Miller 2 Direct Laryngoscope Video Laryngoscope When it’s time to insert an endotracheal tube, for decades anesthesiologists have utilized a direct laryngoscope. Direct laryngoscopy (DL) is a difficult skill to acquire, but all anesthesiologists become masters of it. Enter the video camera, which changed surgical practice. Open […]
Health Care Chessboard: The Evolution of My Practice’s Partnership with a Larger Organization
Authors: Mo Azam, MD, MBA, FASA ASA Monitor August 2024, Vol. 88, 18–19. In 1988, there were 11 anesthesiologists providing services to three facilities in the Florida Hospital system in Orlando. A physician could apply for privileges at the hospital, interview with leaders of the independent medical staff, provide services as an individual, and commit […]
Science, Medicine, and the Anesthesiologist
Anesthesiology September 2024, Vol. 141, A13–A15. Synapse-specific trapping of SNARE machinery proteins in the anesthetized Drosophila brain. J Neurosci 2024; 44:e0588232024. PMID: 38749704. The neuronal mechanisms of general anesthetics are attributed to multiple cellular targets including postsynaptic potentiation of inhibitory ion channels and the inhibition of neurotransmitter release by interference with proteins involved in exocytosis; however, variation may […]